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2=Neurobiology > L4. Anxiety and depression > Flashcards

L4. Anxiety and depression Flashcards

1
Q

3 categories of depressive disorders

A
  1. persistent DD
  2. major DD
  3. bipolar (1 and 2)
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2
Q

how many sxs need to be present for MDD and for how long

A

5sxs (1 must be depressed mood or loss of interest/pleasure)
2 weeks - every day

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3
Q

name 5 sxs of MDD

A
  1. depressed mood
  2. loss of interest/plesure
  3. insomnia/hypersomnia
  4. weight loss/weight gain
  5. indecisiveness/confusion
  6. fatigue
  7. feelings of worthlessness/inappropriate guilt
  8. recurrent thought of death, suicide (suicide attempt)
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4
Q

how many sxs need to be present for PDD and for how long

A

2+depressed mood = 2 years

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5
Q

5 sxs of PDD (ex depressed mood)

A
  1. poor appetite/overeating
  2. insomnia/hypersomnia
  3. feelings of hopelessness
  4. fatigue
  5. low self-esteem
  6. poor concentration
  7. indecisive
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6
Q

general definition of bipolar disorder

A

phases of depression combined with phases of mania

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7
Q

what is bipolar 1 disorder?

A

rapid daily cycling episodes of mania + depression

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8
Q

what is bipolar 2 disorder?

A

recurrent depression + hypomanic episde

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9
Q

main sxs of manic episode

A

abnormal + persistent elevated or irritable mood

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10
Q

how long must a manic episode last for

A

> 1 week

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11
Q

how many other sxs must be present for manic episode diagnosis

A

3 - 4 if irritability is present

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12
Q

5 sxs of manic disorder

A
  1. inflated self-esteem
  2. decreased need for sleep
  3. more talkative
  4. thoughts are racing in head
  5. distractibility
  6. increase in goal-directed actvity
  7. excessive involvement in activities with high potential for painful consequences
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13
Q

what does the monoamine hypothesis suggest depression is caused by?

A

reduction in NA and 5-HT (serotonin) centrally and at synapses

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14
Q

5 classes of antidepressants

A
  1. MAOI
  2. TCAs
  3. SSRIs
  4. SNRIs
  5. mood stabilisers
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15
Q

how do MAOIs work?

A
  1. increase cytoplasmic levels of MA
  2. increased uptake of 5-HT and NE in synaptic vesicle
  3. leakage of MA into extracellular space
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16
Q

what is MA?

A

NT involved in mood

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17
Q

side effect of MAOIs

A

cheese effect - avoid high tyramine diet - MA usually break this down. leads to high BP

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18
Q

1 example of MAOIs

A
  1. phenelzine

2. moclobemide

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19
Q

how do TCA work?

A
  1. block 5-HT + NE reuptake transporters
  2. inhibits reuptake fo 5HT from ECS
  3. leaves more 5HT in synapse
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20
Q

1 example of TCA

A

amitryptaline

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21
Q

how to SSRIs work?

A

inhibt reuptake of 5HT

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22
Q

2 examples of SSRIs

A

sertraline

fluoexteine

23
Q

which have a faster duration of action; SSRIs or SNRIs ?

A

SNRIs

24
Q

2 examples of SNRIs

A
  1. venlafaxine

2. duloxetine

25
Q

who are mood stabilisers most effective in?

A

bipolar pt

26
Q

2 examples of mood stabilisers

A
  1. lithium

2. carbamezepine

27
Q

which atypical antidepressant has reduced SE compared to TCAs and SSRIs

A

NA and specific serotonergic antidepressants

28
Q

1 example of NA and specific serotonergic antidepressants

A

mirtazapine

29
Q

what is Zyban/bupropion used for (2)?

A
  1. smoking cessation

2. DA reuptake inhibitor - antidepressant

30
Q

according to NICE guidelines, what is the 1st line of treatment for depression?

A

CBT

31
Q

generalised anxiety disorder occurs when there is excessive anxiety for how long?

A

> 6m

32
Q

how many sxs required for GAD diagnosis

A

3

33
Q

list 5 sxs of GAD

A
  1. restlessness/on edge
  2. easily fatigued
  3. difficulty concentrating
  4. irritability
  5. muscle tension
  6. sleep disturbance
34
Q

describe onset of panic disorder

A

sudden - within 10 mins

35
Q

2 essential diagnostic criteria for panic disorder

A
  1. intense fear/discomfort

2. 4+ somatic or cognitive sxs

36
Q

list 5 somatic or cognitive sxs for panic disorder

A
  1. palpitations, pounding heart, accelerated HR
  2. sweating
  3. trembling, shaking
  4. sob
  5. feeling of choking
  6. chest pain or discomfort
  7. nausea or abdo distress
  8. dizziness, lightheaded
  9. derelisation/depersonalisation
  10. fear of losing control
  11. fear of dying
  12. paraethesia
  13. chills/hot flushes
37
Q

what is social phobia

A

persistent fear of social/performance situations in which embarassment may occur

38
Q

3 diagnositic criteria for social phobia

A
  1. persistent fear of social settings
  2. fear provokes panic attack
  3. recognition that the feat is excessive or unreasonable
39
Q

what is agoraphobia

A

anxiety/avoidance of places or situations which may be difficult or embarrassing

40
Q

2 brain abnormalities in pt with anxiety disorder

A
  1. size of brain

1. neural activity

41
Q

what is CBT used for

A

social anxiety

42
Q

short term drug used for anxiety disorder

A

benzodiazepine

43
Q

1st line of drug treatment for anxiety disorder

A

SSRIs

44
Q

example of SSRIs

A

fluoxetine, sertraline

45
Q

2nd line of drug treatment for anxiety disorder

A

SSRIs and SNRIs

46
Q

3rd line of drug treatment for anxiety disorder

A

pregabalin

47
Q

3 classes of benzodiazapines (BZ)

A
  1. long acting
  2. intermediate/short acting
  3. ultra-short acting
48
Q

duration of action of intermediate/short acting BZ

A

5-24 hrs

49
Q

example of long acting BZ

A

diazepam

50
Q

site of action in brain of BZ

A

limbic system

51
Q

why must BZ be gradullay reduced and discontinued

A

prevent discontinuation syndrome

52
Q

how do BZ work on GABA receptors?

A

Cl- influx, hyperpolarisation

53
Q

in addition to anxiety disorders, what else are BZ used to treat?

A

alcohol withdrawl

54
Q

4 adverse effects of BZ

A
  1. drowsiness
  2. vertigo
  3. cognitive impairments
  4. aggression

2=Neurobiology (6 decks)

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